[Appropriate hospital utilization in emergency surgery: application of the Appropiatness Evaluation Protocol]

The Authors developed and tested a new version of the Appropriateness Evaluation Protocol (AEP) to review 160 clinical records of the Emergency Surgery Department of Policlinico Umberto I-Rome. The modifications to the AEP also allow to evaluate the appropriate ward of hospitalization of acute patients (Surgery, Orthopedics, Head & Neck, Burns).

26 (16%) out 160 admissions failed the AEP criteria; 85 of the remaining admissions were judged appropriate in the Emergency Surgery Department (53% of the whole sample), 14 (9%) in the Head & Neck Department, 10 (6%) in the Orthopedic Department, 25 (16%) not in an Emergency Surgery Department. Only 63% of the appropriate admissions has been judged adequate in the Emergency Surgery Department. The Authors conclude that it is necessary to improve the primary "filter" of the hospitalization (the ambulatory care component of the National Health System). Finally, this version of the AEP was shown to be reliable, an useful tool in the hands of trained physicians.